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IM2 > Calcium (Regular, hypo, & hypercalcemia) > Flashcards

Calcium (Regular, hypo, & hypercalcemia) Flashcards

1
Q

what is the range of calcium

A

8.5 - 10.5

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2
Q

Ca is best friends with which electrolyte

A

Mg

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3
Q

when Ca goes up, Mg goes

A

up

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4
Q

when Mg is low calcium does what for Mg

A

it helps Mg with the function

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5
Q

Ca keeps the 3 B’s what

A

strong

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6
Q

what are the 3 B’s

A

Bone - 90% of the body’s calcium
Blood clotting
Beat (hr) myocardial contraction

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7
Q

where does 90% of the body’s Ca go

A

the bones

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8
Q

what 3 hormones regulate Ca

A

parathyroid
calcitonin
calcitrol

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9
Q

the parathyroid hormone is made and released by what gland

A

parathyroid gland

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10
Q

when Ca+ levels are low what hormone elevates them

A

PTH

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11
Q

calcitonin is regulated by what gland

A

thyroid gland

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12
Q

when Ca+ levels are high, what is released to lower Ca+ and put it back in the bones

A

calcitonin

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13
Q

calcitrol controls blood calcium by suppressing the release of what

A

PTH

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14
Q

what is the normal range of ionized calcium

A

4.8-5.6

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15
Q

What is ionized calcium

A

calcium in blood not attached to proteins (free calcium)

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16
Q

what is the most accurate test for assessing true calcium status

A

an ionized calcium test

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17
Q

why is ionized calcium important

A

important of there are abnormal levels of protein

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18
Q

what signs of these diseases would ionized calcium be drawn (3)

A

if there are signs of kidney
liver
parathyroid

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19
Q

what causes hypocalcemia (7)

A

vitamin D deficiency
long-term corticosteroids usage
hypoparathyroidism
renal disease
massive diarrhea
hyperphosphatemia
meds

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20
Q

what is required for absorption of Ca

A

Vitamin D

21
Q

what can cause hypoparathyroidism (2)

A

decrease in parathyroid hormone
removal of parathyroid glands

22
Q

why does hyperphosphatemia cause hypocalcemia

A

because phospate is in an inverse relationship with calcium

23
Q

what meds can cause hypocalcemia (3)

A

diuretics
laxitives
corticosteroids (contribute to bone loss)

24
Q

what surgeries can cause possible hypocalcemia due to irritating/possibly removing the parathyroid glands (2)

A

thyroidectomy
any neck surgeries

25
Q

how will the cardiovascular system appear in a pt who has hypocalcemia (3)

A

hypotension
dysrhythmias (V Tach)
decreased hr

26
Q

how will the neuromuscular system appear in a pt with hypocalcemia (5)

A

irritable skeletal muscles - twitching, cramps, tetany, seizures, paresthesias
painful muscle spasms in calf/foot
positive Trousseau’s & Chvostek’s signs
hyperactive DTRs
osteoporosis - body trying to get more calcium

27
Q

how will the GI system appear in a pt who has hypocalcemia (2)

A

hyperactive bowel sounds
diarrhea

28
Q

what is a positive sign of Chvostek’s look like

A

when taping the masseter on the face, the muscles will contract/twitch

29
Q

what is a positive Trousseau’s sign

A

get a bp cuff and inflate higher than pt’s normal systolic
hold for 3 mins
pos sign: hands draw in as thumb, wrist, & MCP joints flex, fingers stay extended

30
Q

what are the interventions for hypocalcemia

A

replace calcium (IV or PO)
Initiate seizure & bleeding precautions
Move pt carefully
Educate on calcium-rich food

31
Q

what IV fluid can we give to replace calcium

A

calcium gluconate 10%

32
Q

how long should we give calcium gluconate

A

over 10-20 mins

33
Q

what PO meds should we give to replace calcium (2)

A

Vitamin D tab
Aluminum hydroxide (Tums) calcium supplements

34
Q

what causes hypercalcemia (4)

A

hyperpararthyroidism
Antacids
Malignancies
Renal disease - inability to excrete

35
Q

how do antacids cause hypercalcemia

A

there is an excess intake of calcium & vitamin D

36
Q

what malignancies cause hypercalemia (2)

A

bone malignancies
bone destruction

37
Q

what is released into the bloodstream with bone malignancies

A

calcium

38
Q

how will a pt’s neuromuscular appear when they have hypercalcemia (2)

A

muscle weakness
diminished or absent DTRs

39
Q

what type of bowel sounds will we hear in a pt who has hypercalcemia

A

hypoactive bowel sounds

40
Q

what do hypoactive bowel sounds in hypercalcemia indicate

A

constipation

41
Q

what will form in the kidneys when a pt has hypercalcemia

A

kidney stones

42
Q

what interventions do we do for hypercalcemia (6)

A

Admin IV fluids
Discontinue calcium
Loop diuretics
Meds
Dialysis if meds fail
Educate on avoiding calcium rich foods

43
Q

what IV fluid is admined to pt with hypercalcemia

A

0.9% NS

44
Q

why is NS the fluid used for a pt with hypercalcemia

A

to help them excrete the calcium

45
Q

what meds need to be discontinued in a pt with hypercalcemia

A

oral meds w/ calcium & vitamin D

46
Q

what loop diuretic would be admined to a pt with hypercalcemia

A

furosemide (lasix)

47
Q

what meds would be given to a pt with hyper calcemia (3)

A

phosphorus (inverse relationship w/ Ca)
calcitonin
bisphophonates

48
Q

What do IV NS & loop diuretics indicate about a pt with hypercalcemia

A

less severe form of hypercalcemia

IM2 (17 decks)

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